Provider Demographics
NPI:1801837877
Name:SHAW, KAREN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:SHAW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5989
Mailing Address - Country:US
Mailing Address - Phone:252-355-7429
Mailing Address - Fax:252-355-4582
Practice Address - Street 1:1100 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5989
Practice Address - Country:US
Practice Address - Phone:252-355-7429
Practice Address - Fax:252-355-4582
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC54581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice